'When you hear hoofbeats, think of horses not zebras' - the old adage is well-known to GPs but what should you do when faced with a zebra, not a horse? Consultant cardiologist Professor Robert Tulloh and GP Dr Louise Tulloh kick off our new series with their advice on how to catch Kawasaki disease in general practice.

New 28-day repeat script plan 'crazy'

The GPC has condemned as 'crazy' attempts by PCTs to impose blanket 28-day repeat prescribing intervals on GPs.

Several trusts have standardised prescribing intervals for all or most drugs after pressure from pharmacists, who argue it cuts drug wastage.

Dr Peter Fellows, chair

of the GPC prescribing sub-committee, said the move was 'shortsighted, crazy administration'.

Dr Fellows, a GP in Lydney, Gloucestershire, said repeat prescribing took up 'huge amounts of time' and 28-day intervals could prove more expensive for PCTs in the long run. He said: 'It's entirely appropriate to prescribe for much longer periods for stable diseases or things like the contraceptive pill.'

PCTs in Northumberland and North Nottinghamshire have already introduced 28-day prescribing intervals while others, such as Exeter, are trying to impose the policy.

Exeter GP Dr Adrian Midgley said he faced 'constant nagging' from his trust to switch to 28-day prescribing, even with cheap drugs such as aspirin, digoxin and thyroxine.

He dismissed the initiative as 'voodoo economics'. He said: 'This is an effort to save £10 once in a patient's lifetime by spending £10 per month of a doctor's time. It's a great scene when you're in the consulting room saying "You've got ischaemic heart disease and I want you to take one aspirin a day for the rest of your life ­ here's 28 days' supply''.'